422 NE 93 St (2)ick
cy MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 7
Registered Architect and/or En eer
Employing Plumber's Name JA) k.
NO. 199•1
Location and Legal Description Lot
Street and Number where work is to be performed—No
State work to be performell and purpose of building (By Floors)
New Building_ Remodeling Addition. Repairs No. of Stories... ............
Size Septic Tank_
Feet of Drain
Nature of Water Su
_Type of Tank.
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Bloe1
Street
Capacity Gals
Date J-P
/
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 0.4 ./ employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Su:( ment, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed u er this permit, as are
licensed by Miami Shores Village.
, -
P1 II Iing Inspector:
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Fknida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notica for insi n, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
...
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTE
SW IM •G
P001.
-
cetera.
LIST
I'
CHECK
ick
cy MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 7
Registered Architect and/or En eer
Employing Plumber's Name JA) k.
NO. 199•1
Location and Legal Description Lot
Street and Number where work is to be performed—No
State work to be performell and purpose of building (By Floors)
New Building_ Remodeling Addition. Repairs No. of Stories... ............
Size Septic Tank_
Feet of Drain
Nature of Water Su
_Type of Tank.
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Bloe1
Street
Capacity Gals
Date J-P
/
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 0.4 ./ employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Su:( ment, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed u er this permit, as are
licensed by Miami Shores Village.
, -
P1 II Iing Inspector:
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Fknida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notica for insi n, or faulty
materials and/or workmanship.
r
r .
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
a FOR ELECTRICAL PERMIT
Permit No riVn
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work
Owner's Name and Address YgkR Co �.: � No
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No
STATE OF FLORIDA,
COUNTY OF DADE. f ss '
y a!
Block Subdivision,
(Signed)
?fi
6� C
Date
Street
k
Street 6 i /
Street -
State work to be performed and purpose of building (By Floors) - -t.._
New Building r y Remodeling Addition Repairs No. of Stories
ServioOverhead 'Size Feeders/ 17 / Conduit Main Sw Amps Main Fuses ,.4
Underground,
Type of Installation— Conduit Tubing a. B.X.L .Metal Moulding
Amount of Permit $ r (Signed)
r ` Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Pt Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T's
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
yr
2c,
/Jul ✓
d
G C+
/
___z_
CHECK
ENT.
SW.
DIET.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
1 ,f o
� �
,
CHECK
r
r .
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
a FOR ELECTRICAL PERMIT
Permit No riVn
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work
Owner's Name and Address YgkR Co �.: � No
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No
STATE OF FLORIDA,
COUNTY OF DADE. f ss '
y a!
Block Subdivision,
(Signed)
?fi
6� C
Date
Street
k
Street 6 i /
Street -
State work to be performed and purpose of building (By Floors) - -t.._
New Building r y Remodeling Addition Repairs No. of Stories
ServioOverhead 'Size Feeders/ 17 / Conduit Main Sw Amps Main Fuses ,.4
Underground,
Type of Installation— Conduit Tubing a. B.X.L .Metal Moulding
Amount of Permit $ r (Signed)
r ` Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Pt Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
///
Permit No.- _ 0)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is de in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of th to of , all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be Nether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address_
Registered Architect and /or
Employing Plumber's Name
Location and Legal Description
Street and Number where work is to be performed —
State work to be performed and purpose of building
New Building -- - - - - - Remodeling
Size Septic Tank_ ---
of Tank
Feet of Drain Tile__ Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. - - -_- _ _..... __...... _--- ___- _- ... __ -- _._Size of Soakage Pit .__._.__ _ --
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition____ Repairs___ No. of Stories..
(Signed)-
Plumbing Inspect
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig fans as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinan ;T Supplement, and has com-
plier with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl• by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed and is , permit, as are
licensed by Miami Shores Village.
(Signed)
2 .... -- — —
Capacity Gals
My Commission Expires Notary Public, State of Florida
aster Plumber.
STATE OF FLORIDA, es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _-- ---- - - ---- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for insp ' 9n, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SH OWER!
LAVA-
TORIES
S INKS
SLOP
SINKS
LAUNDRY
TUBS
URINAL i
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
`—
TOTAL
FIXTURE6
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM •G
POOL
CONTR.
LIST
CHECK
///
Permit No.- _ 0)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is de in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of th to of , all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be Nether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address_
Registered Architect and /or
Employing Plumber's Name
Location and Legal Description
Street and Number where work is to be performed —
State work to be performed and purpose of building
New Building -- - - - - - Remodeling
Size Septic Tank_ ---
of Tank
Feet of Drain Tile__ Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. - - -_- _ _..... __...... _--- ___- _- ... __ -- _._Size of Soakage Pit .__._.__ _ --
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition____ Repairs___ No. of Stories..
(Signed)-
Plumbing Inspect
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig fans as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinan ;T Supplement, and has com-
plier with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl• by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed and is , permit, as are
licensed by Miami Shores Village.
(Signed)
2 .... -- — —
Capacity Gals
My Commission Expires Notary Public, State of Florida
aster Plumber.
STATE OF FLORIDA, es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _-- ---- - - ---- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for insp ' 9n, or faulty
materials and /or workmanship.
ASSEMBLY
LOCATION
'
1
2
3
4
INST
REM
INST
REM
INST
REM
INST
REM
ACCOUNT 366/366.7 (
RWO ER
Date
Date
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ACCOUNT 367/367.7
C11 19∎21 1 ' 1 1 1
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4
ACCOUNT 368
Li1;4j1i -1 1 1
1 1 1 1 1 1
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ACCOUNT 369
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CONDUCTOR — 367/3671;c
INST
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• I ■ _ _ e — 369
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Trench
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Duck Bk
Fcet
Neutral
Fcet
600V Cable Feet
INCH CA LE NORTH
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Buried
Other
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/20
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_ OK
_ III���
Descriptiv
Title OV I t /20 �L.—i�L' J�V /Ci�' L V
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Reviewed by Dist. /Div. Engr.
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Load
Data (• Q A�Ips _ y r � } c
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MAP
M
M A,
Date
Service
Required
f L/ /S /�Q
Cust.
Added
/
Ear
/•
,'i 7
Orig. W.O. No.
—
Certified Complete — Supervisor
Authorized — Manager
RWO ER
Date
Date
CyJNDERGROUND/URD INVENTORY SKETCH
OUP WORK ORDERS ONLY)
GROUP W.O. NO
ER. NO.
4 r)
LOC'N CODE
gq9
DIST
rY,
INV.
SKETCH
NUMBER
SERVICE CENTER
N [,J S C
FORM 160 REV. 3/69
Permit No I Z ' C ' .
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
. e0/4 - 2 4 ......
Registered Architect and /or Engin r _____— __-- _______ -___ - - - -- _ _ --
Employing Plumber's Name _._. f O Q __ 4_y_ , ai / �.__ No-Y Street___ / yX7 _._ 7a'v' 4 �/
Location and Legal Description Lot_ -__ --- ` - i 0 Block `S Subdivision__ �. I 'LLLiker: )#z-._
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors ) _
New Building _-__4 Remodeling- ----- _------ --- -- -- ---- Addition__
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $
q f - - - -- - - -- - - - - - - -- - ------------- - - - - -- -
u 3 ' _ - - -- — -- - — — (Signed)_ - — —
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street - -- 4 7 ' _.9_
(Signed)__
Repairs No. of Stories.. _.
Capacity Gals
Type of Tank
Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
to me well known, and who, being by me first duly sworn, upon oath deposes and - that he is the_ .
of the above described_ construction, that he has carefully read the foregoing a • . I ation, and tha
therein by him stat �1r i t LlC, STATE of FLORIDA ®t LARD!
LlX COMMISSION IHRR F D _
My Commission Expires
Date / — `° -
— Street_ /r 2 J 5 +
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe anent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
gn ilie same, and that all facts
blic, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIEB
SINKS
SLOP
SINKS
LAUNDRY
TUBS
INALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CONTR.
LIST
I
'
L
I
j
9
CHICK
qI'._
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOMPIR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
C
jC/(
sQw/ e.e.
—_
COHTR.
LIST
/
J
/
—
CHICK
Permit No I Z ' C ' .
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
. e0/4 - 2 4 ......
Registered Architect and /or Engin r _____— __-- _______ -___ - - - -- _ _ --
Employing Plumber's Name _._. f O Q __ 4_y_ , ai / �.__ No-Y Street___ / yX7 _._ 7a'v' 4 �/
Location and Legal Description Lot_ -__ --- ` - i 0 Block `S Subdivision__ �. I 'LLLiker: )#z-._
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors ) _
New Building _-__4 Remodeling- ----- _------ --- -- -- ---- Addition__
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $
q f - - - -- - - -- - - - - - - -- - ------------- - - - - -- -
u 3 ' _ - - -- — -- - — — (Signed)_ - — —
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street - -- 4 7 ' _.9_
(Signed)__
Repairs No. of Stories.. _.
Capacity Gals
Type of Tank
Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
to me well known, and who, being by me first duly sworn, upon oath deposes and - that he is the_ .
of the above described_ construction, that he has carefully read the foregoing a • . I ation, and tha
therein by him stat �1r i t LlC, STATE of FLORIDA ®t LARD!
LlX COMMISSION IHRR F D _
My Commission Expires
Date / — `° -
— Street_ /r 2 J 5 +
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe anent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
gn ilie same, and that all facts
blic, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT e
Permit No '4 1 Date a �
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. �+ (/)..)".-
Owner's Name and Address. . .2.�I°t qq - A/ �rl" No At. " Street �"
Employing Electrician's Name /61 , z- cl e C No.29a 4-
Registered Architect and /or Engineer
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors) i
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ {0..1.
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Matter Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. I °°
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUO
RECE'P'T's
FIXTURES
NO. LAMPS
RtrRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 MP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
3
CHICK
•
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT e
Permit No '4 1 Date a �
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. �+ (/)..)".-
Owner's Name and Address. . .2.�I°t qq - A/ �rl" No At. " Street �"
Employing Electrician's Name /61 , z- cl e C No.29a 4-
Registered Architect and /or Engineer
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors) i
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ {0..1.
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Matter Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. I °°
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
\ A P
STATE OF FLOFIDA, 1 .
COUNTY OF DADE. j ss.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
LICATION FOR BUILDING PERMIT
Application is hereby uinde for lc approval of the detailed statement or the plans and specifications herewith submitted for the build •
ing or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Ov.ncr's Name and Address . .. Oa/4A __ — No. 4 Street_.. :.. S7-
r _
Registered Architect and /or lyngineer..... � /..�..�/ �/'"'/ .... ......ft .�f�,l�Fm'S' ....,. •,,..,,n + =.. «.•.,.,,,,, ,.„,.
Name and address of licensed contractor r. 4r 1 _ ST ..._. ...— ..... — »..
Location and legal description of lot to be built on:
Lot 9 . ve-/e Block Subdivision /. i.4 !2d r�. Q�wF..6.°:..- • ••> L ?'
.e a
Street and Number where work is to be done _ r'
State work to be done and purpose of building (by floors) _ _ --•• - - -•• --
and for no other purpose.
New Bui!ding Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation joof Covering
Estimated Total cost of improvements $ ,/7Qai2 Amount of Permit S....
Zone cubage required plan Cubage
Distance .to next nearest building Size of Building Lot
Maximum lire load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
•
be sent to.. c/..! p . T�.R.!C.O.....vCS'.T_'... /.G.t
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the 'Florida %Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require s 'lar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
ss�•ral:• � � ��
Remarks
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared__._ .. _..._...._ ..................
me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true..
Permit No ZULU/' Date 3 .1112 Read, Sworn to and Subscribed before me.
Disapproved .... 4 . Date
(Signed)
Notary Public, State of Florida
Building Inspector My Commiuion Expires
PLANNING BOARD DATE
Crhair,nan Member
Member Member
Member .. .. Member _ — .- ... -- --• -•
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the I'Iupnir.g Board.
A re-inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.